American journal of preventive medicine
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To describe characteristics of persons with late (at or after death) acquired immunodeficiency syndrome (AIDS) diagnosis, we analyzed national surveillance data among all persons with AIDS diagnosed through December 1991 under the pre-1993 AIDS case definition and with a known date of death. Late diagnosis was present in 15.8% of 163,202 decreased persons with AIDS and in 15.3% of decreased men with AIDS, 20.6% of women, 12.1% of whites, 20.0% of blacks, 21.1% of Hispanics, 12.3% of men who have sex with men (MSM), 21.9% of injecting drug users (IDU), and 19.6% of persons exposed to human immunodeficiency virus (HIV) through heterosexual contact. ⋯ Late AIDS diagnosis, especially among ethnic minorities and IDU and their sex partners, may represent delays in HIV diagnosis and care. In addition to not receiving early clinical intervention, persons who are diagnosed later in the course of HIV disease represent missed opportunities for receiving prevention efforts such as education, counseling, and substance abuse treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Recent reviews of medical education at the undergraduate and graduate level call for a greater emphasis on community-relevant teaching and development of partnerships between providers, academic health centers, and the community. The cluster committee, developed by the Center for Community Responsive Care, Inc., sets the stage. ⋯ It is designed to meet the following goals: initiate the fellow in the steps of community-oriented primary care (COPC); develop a fellow's leadership skills; encourage relationships and coalitions within the community and among providers; and bring together the perspectives of community members, public health practitioners, academicians, and local clinicians regarding community health, as well as teach each about COPC. This article describes the cluster committee process, provides examples of a series of meetings, and presents lessons learned from the first six years of implementation.
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Comparative Study
Health promotion and disease prevention in health care reform.
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Review Comparative Study
Cardiovascular disease risk factors in native Americans: a literature review.
Cardiovascular disease (CVD) has become the leading cause of death for Native Americans and Alaska Natives. CVD risk factors (diabetes, hypertension, obesity, hypercholesterolemia, smoking, and sedentary lifestyle) have been studied in a number of Native American tribes, and such studies are increasing as the CVD mortality rate rises. This article reviews the literature between 1980 and 1991 concerning the prevalence of CVD risk factors in this population. In addition to summarizing the data, we describe limitations inherent in comparison and address the need for standardization of methodology in future studies.